title: A diagnostic dilemma between psychosis and post-traumatic stress disorder: a case report and review of the literature.
abstract: BACKGROUND
  Post-traumatic stress disorder is defined as a mental disorder that arises from the experience of traumatic life events. Research has shown a high incidence of co-morbidity between post-traumatic stress disorder and psychosis.
  
  
  METHODS
  We report the case of a 32-year-old black African woman with a history of both post-traumatic stress disorder and psychosis. Two years ago she presented to mental health services with auditory and visual hallucinations, persecutory delusions, suicidal ideation, recurring nightmares, hyper-arousal, and initial and middle insomnia. She was prescribed trifluoperazine (5 mg/day) and began cognitive-behavioral therapy for psychosis. Her psychotic symptoms gradually resolved over a period of three weeks; however, she continues to experience ongoing symptoms of post-traumatic stress disorder. In our case report, we review both the diagnostic and treatment issues regarding post-traumatic stress disorder with psychotic symptoms.
  
  
  CONCLUSIONS
  There are many factors responsible for the symptoms that occur in response to a traumatic event, including cognitive, affective and environmental factors. These factors may predispose both to the development of post-traumatic stress disorder and/or psychotic disorders. The independent diagnosis of post-traumatic stress disorder with psychotic features remains an open issue. A psychological formulation is essential regarding the appropriate treatment in a clinical setting.
authors.affiliation: Lambeth Early Onset (LEO) Service, Lambeth Hospital, South London and Maudsley NHS Trust, 108 Landor Road, London SW9 9NT, UK. Ricardo.Coentre@netc.pt.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Coentre
authors.forename: Paddy
authors.initials: P
authors.lastname: Power